It took me a long time to review this book and it wasn't the book's fault. I received it right before having major surgery so I miscalculated how long it would take me to fully recover.

I have fibromyalgia along with other health problems. So much of what is spoken in this book relates to those of us dealing with chronic pain and illness. Some things I figured out on my own like my gluten intolerance and how it added to my inflammation/pain. Pacing is the most difficult to practice so I will definitely be rereading those chapters. I also need to work on taking refined sugar our of my diet again. This book is practical and left me with a lot of food for thought.

I appreciated how the authors made bullet points at the end of chapters, including personal stories and an extensive appendix. Honestly so much of what they share in this book seems like common sense and I'm left asking myself why didn't I think of it. This is definitely a book I'll be rereading. I also plan on buying a physical copy of for myself and possibly gifting it to other spoonies (chronic illness folks). ( )

This is the second book in the series and is much more of the "How to" guide.

I was heartened that at no point is the author selling this as a cure, it isn't and there is not one. As a patient of 26 years and counting I wish this book had been available when I became ill, it would have saved me a great deal of heartache and precious energy.

Most of what is recommended is sensible common sense and is pretty much what I learnt myself independently: good diet, a support network, pacing etc. I do however want to raise a note of caution, the advice on pacing is fine but limited and the pitfalls are only discussed a couple of chapters further on: not everyone is adept at noticing when to stop and the nature of PEM means when you do notice it is much too late. Pacing with a heart rate monitor really does make a difference and for myself has halted a continual decline.

I would absolutely recommend this book to patients with ME/CFS and long COVID no matter how longstanding the diagnosis. ( )

Take It Slow and Gentle
Book Review by Erin Michaela Sweeney

Steven J. Sommer was a general physician in Australia when he ended up with ME/CFS, a chronic illness of debilitating fatigue. After writing a memoir of how he healed himself, he wrote a second book -- this one, A Path Back to Life -- to share the steps people can take to improve their lives after an ME/CFS diagnosis. Along with many references to chapters in his memoir, Sommer highlights stories of patients that he's helped with his Micro-Rehab concepts.

The opening chapters present a history of medicine. As scientists pursued ways to battle the microbe, or external compromises to health, they ignored the terrain, originally coined intérieur milieu, in which the body maintains its internal environment, including breath rate, heart rate, blood pressure, body temperature, pH, and immune defenses, in response to the external environment. Sommer focuses on individualized lifestyle treatments to adjust the terrain of ME/CFS patients for the better.

Sommer defends his individualized approach, which he calls N-of-1 Research, by explaining that not all cookie-cutter approaches work for each person. Though scientific research points to some possible improvements with one or another technique, the thousands of patients in a study might not suffer in the same way with the same symptoms as an individual reader. Therefore, it's try and try again for each, with a baseline (before), more measurements during, and comparison of data after for each lifestyle change. It's also important to have doctors willing to support the patient at each step. Sommer says a multidisciplinary team must put the ME/CFS person front and center as that person develops self-awareness in reading their body.

Some symptoms/diagnoses specific to ME/CFS patients that Sommer mentions include Neurally Mediated Hypotension (NMH), Postural Orthostatic Tachycardia Syndrome (POTS), Orthostatic Intolerance (OI), Post-Exertional Malaise (PEM), coexisting anxiety and sometimes depression, sensitivities to medication, herbal treatments, noise, fragrances, visual and auditory overstimulation, emotional stress, dysbiosis, low: DHEA-S, Vitamin D3, B12 and folate, methylation performance, essential fatty acids, Vitamin C, biotin, niacin, selenium, zinc, magnesium, CoQ10, D-ribose.

In the later chapters, Sommer explains his Fundamental 4, which boost the terrain for all chronic illnesses, and the Specific 4, which are strategies for ME/CFS patients in particular.
The Fundamental 4 are: Social Support (Chapter 7), Restorative Sleep (Chapter 8), Nourishing Diet (Chapters 9-10), and Movement (Chapter 11).
The Specific 4 are: Pacing (Chapter 11), Micro-Rehab (Chapters 12-13), Mind-Body Therapies, and Restoring Body-Mind Trust (Chapters 14-15).

Basically, the Art of Micro-Rehab means taking things slowly, methodically, and gently. For instance, have baseline measurements/data of how you sleep now (how many hours, how long does it take to get to sleep, do you awaken in the night, etc.), test only one change, perhaps going to bed at the same time each night, while accumulating measurements/data to find out if, after weeks or months, going to sleep at the same time each night improves your life, then return to how you were before the change, that is, back to going to sleep whenever, for several weeks or months, to see if your life declines without going to sleep at the same time each night. If going to sleep at the same time each night helped, reintegrate it into your life. Proceed to the next lifestyle change.

Though there's lots of information in this book, I wonder if someone suffering with ME/CFS has the physical, mental, and emotional stamina and patience to work through the recommendations without setbacks. Also, many of the tests to determine specific symptoms/diagnoses relevant to ME/CFS patients as well as ongoing blood tests to monitor improvements in low levels of vitamins, etc., are costly, as are much of the recommended complementary therapies. Finally, the non-American spellings, typos, and errors in formatting can be distracting.

Overall, A Path Back to Life: The Art of Micro Rehab by Steven Sommer is a helpful guide for many in the ME/CFS community and a useful addition to the available literature.

*I received a free ebook of A Path Back to Life: The Art of Micro Rehab as a LibraryThing Early Reviewer member in exchange for an unbiased review. (This review also appears on Amazon). ( )

A compassionate and realistic guide to living with chronic fatigue. The author, a medical doctor, offers sound advice based on personal experience and ample research. ( )